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29.08.2016 | Affektive Störungen | Leitthema

Affektive Störungen in der Schwangerschaft

Therapie mit Antidepressiva und Mood Stabilizern

verfasst von: PD Dr. Dr N. Bergemann, W. E. Paulus

Erschienen in: Der Nervenarzt | Ausgabe 9/2016

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Zusammenfassung

Hintergrund

In der Schwangerschaft kommt es nicht selten zu einer Erstmanifestation oder einem Rückfall einer affektiven Erkrankung. Wenn eine pharmakologische Behandlung indiziert ist, bedarf es einer möglichst sicheren Grundlage für die Auswahl einer in der Schwangerschaft geeigneten Substanz. Aber auch bereits bei der Auswahl eines Psychopharmakons bei Frauen im gebärfähigen Alter sollte die Verträglichkeit der Substanz in der Schwangerschaft berücksichtigt werden, da ein sehr hoher Prozentsatz der Schwangerschaften ungeplant eintritt.

Fragestellung

Bei der Beurteilung von Risiko und Nutzen einer Psychopharmakotherapie in der Schwangerschaft und bei Schwangerschaftswunsch muss nicht nur die Frage nach der potenziellen Gefährdung des Kindes durch teratogene Medikamenteneffekte geklärt werden, sondern auch die Frage nach möglichen Schwangerschafts- oder peripartalen Komplikationen und neuropsychologischen Langzeitfolgen.

Methode

Es wird ein zusammenfassender Überblick über die aktuelle Literatur zum Einsatz von Antidepressiva und Mood Stabilizer in der Schwangerschaft gegeben.

Ergebnisse

Es liegen zunehmend belastbare Daten für eine Reihe von Antidepressiva und Mood Stabilizer vor, die eine gute Einschätzung ihrer Eignung in Schwangerschaft und Stillzeit erlauben.

Schlussfolgerungen

Bei der Behandlung affektiver Störungen in der Schwangerschaft bedarf es einer individuellen Nutzen-Risiko-Abwägung zwischen der Gefährdung von Mutter und Kind aufgrund einer möglicherweise nicht ausreichend behandelten affektiven Erkrankung ohne Medikation und einer angemessenen Behandlung, die den Einsatz einer Medikation einschließt, auch wenn sie eine potenzielle Gefährdung des Kindes darstellen kann. Bei geeigneter Auswahl des Psychopharmakons in der Schwangerschaft und bei Nutzung des therapeutischen Drug-Monitorings kann das Risiko für Mutter und Kind minimiert werden.

Parameter des APGAR-Scores: Atmung, Puls (Herzaktion), Grundtonus (Muskeltonus), Aussehen (Hautfarbe), Reflexe (Absaugreflexe).

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Titel: Affektive Störungen in der Schwangerschaft
Therapie mit Antidepressiva und Mood Stabilizern
verfasst von: PD Dr. Dr N. Bergemann
W. E. Paulus
Publikationsdatum: 29.08.2016
Verlag: Springer Berlin Heidelberg
Schlagwörter: Affektive Störungen
Affektive Störungen
Antidepressiva
Antidepressiva
Erschienen in: Der Nervenarzt / Ausgabe 9/2016
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI: https://doi.org/10.1007/s00115-016-0194-x

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Mittelgradige Depressionen & Johanniskraut: Das hat sich geändert

Affektive Störungen

Die Behandlungsempfehlungen bei mittelgradiger Depression wurden erneuert und der Einsatz von Johanniskraut entscheidend präzisiert – welche zwei Empfehlungen Sie aus der aktualisierten Depressions-Leitlinie jetzt kennen sollten.

3 Kernaussagen: Cochrane-Analyse untersucht Johanniskrautextrakte

Affektive Störungen

Johanniskraut gehört zu den am besten untersuchten pflanzlichen Arzneimitteln. Die Ergebnisse zur Wirksamkeit bei Depressionen wurden u. a. in einem Cochrane-Review analysiert [1]. Wie das pflanzliche Antidepressivum dabei abschnitt und welche drei Kernaussagen Sie für die Praxis kennen sollten, lesen Sie hier.

Depression behandeln. Natürlich.

Content Hub

Aktuelle Ergebnisse aus in-vitro- und in-vivo-Untersuchungen liefern detaillierte Erklärungen zum Wirkmechanismus von hochdosiertem Johanniskraut-Extrakt: Neu ist die Erkenntnis, dass der Johanniskraut-Extrakt bei chronischem Stress die deregulierte Stressantwort der überaktiven HPA-Achse sowie die Expression des Stressgens FKBP5 normalisieren kann. Mehr zum aktuellen Stand der Wissenschaft bei der Therapie von Depressionen erfahren Sie hier.

Springer Medizin

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Passend zum Thema

Mittelgradige Depressionen & Johanniskraut: Das hat sich geändert

3 Kernaussagen: Cochrane-Analyse untersucht Johanniskrautextrakte

Depression behandeln. Natürlich.